One of the reported advantages of hormone pellets over typical oral and transdermal creams or patch forms of therapy — which produce “roller coaster” hormone levels, resulting in mood and energy fluctuations for the patient — Hormone Pellet Therapy is the only method of hormone therapy that provides sustained hormone levels throughout the day for up to 3 to 6 months without any “roller coaster” effect. The pellets have a physiologic pulsatile dosing effect that parallels the patients’ needs based on cardiac output and demands. For instance, during exercise, there is a greater release of the hormone from the pellet which is very similar to what a person’s body would have done naturally from ovaries, adrenals, and testicles.

Because the hormones used are completely natural, pellet therapy is ideal for patients who want the benefits of a natural hormone without the drawbacks of a synthetic hormone.

What are Hormone Pellets?

Pellets contain a natural plant source of estrogen or testosterone. A compounding pharmacist, using strict federal guidelines, compounds the estrogen or testosterone used in the pellets.

The hormone pellet implantation procedure is easily performed in the office. The insertion of pellets is a simple, relatively painless procedure done under local anesthesia. These pellets, which are about the size of a grain of rice or “tic-tac”, are placed in the fatty tissue underneath the skin around the buttock, hip or abdominal area through a small incision which is taped closed. No sutures or stiches required.

What are some advantages of Pellets for hormone replacement?

In studies and even routine patient reporting, when compared to conventional hormone replacement therapy, pellets have been shown to be superior for relief of menopausal symptoms, maintenance of bone density, restoration of sleep patterns, improvement in sex drive/ libido, sexual response and performance. Also, when on hormone replacement therapy the following has been reported: an Increase in energy, sense of well-being, increased muscle mass and strength and stamina. Decreased frequency and severity of migraine headache. Decrease in mood swings, anxiety and irritability. Decreased obesity. Decrease in risk or severity of diabetes. Decreased risk of heart disease. Decreased risk of Alzheimer’s and dementia.

What if I failed hormone therapy before?

Even patients who have failed other types of hormone therapy have a very high success rate with pellets. In addition, there is no other method of hormone delivery that is as convenient for the patient as pellets since the patient does not have to worry about taking pills or applying creams 1-3 times per day but can just let the pellets work on their own.

What is the history of pellets being used for hormonal replacement?

Pellets have been used in both men and women since the late 1930’s. In fact, there is more data to support the use of pellets than any other method of delivery of hormones. Pellets are not patented and not marketed in the United States. They are frequently used in Europe and Australia where pharmaceutical companies produce pellets. Most of the research on pellets is out of England and Australia with some from Germany and the Netherlands. Pellets were frequently used in the United States from about 1940 through the late 70’s, early 80’s when patented estrogens were marketed to the public. In fact, some of the most exciting data on hormone implants in breast cancer patients is out of the United States showing reduction of breast cancer incidence in patients doing testosterone pellets.

What are potential complications from inserting hormone pellets?

Complications from the insertion of pellets include minor bleeding, bruising, discoloration of the skin, infection, and possible extrusion of the pellet. Other than slight bruising, or discoloration of the skin these complications are very rare. Extended exposure to moisture (swimming, hot tubs, bath tubs) is avoided for 4 to 5 days, and vigorous physical activity is avoided for 48 hours in women and up to 5 to 7 days in men. Antibiotics may be given if a patient is diabetic or has recently had a joint replaced.

What can I expect after pellet insertion?

After pellets are inserted, patients may notice that they have more energy, sleep better and feel happier. Muscle mass and bone density will increase while fatty tissue decreases. Patients may notice increased strength, co-ordination and physical performance. They may see an improvement in skin tone and hair texture. Concentration and memory may improve as will overall physical and sexual health.

What are the most common side effects when the pellets are first inserted?

When a patient first starts hormone therapy there may be mild, temporary breast tenderness; which gets better on its own. Hormone receptors may be very sensitive and take time to adjust. There may be a temporary water weight gain which will also resolve on its own. The body will tone up, as bone density and muscle mass increase and fatty tissue decreases. Patients may experience a mild form of “puberty” as their hormonal levels come up into normal ranges and the body “wakes up” from its hibernation.

How soon will I feel the effects of the pellets?

Some patients begin to “feel better” within 24-48 hours while others may take a week or two to notice a difference.

How long before the pellets need to be replaced?

The pellets usually last between 3-5 months in women and 5-6 months in men. High levels of stress, physical activity, some medications and lack of sleep may increase the rate at which the pellet absorb and may require that pellets are inserted sooner in some patients.

Do the pellets need to be removed every 3-6 months?

No, the pellets do not need to be removed. They completely dissolve on their own.

Do men need hormone replacement?

Testosterone levels begin to decline in men beginning in their 30’s. Most men maintain adequate levels of testosterone into their mid-40’s to mid-50’s, some into their late 70’s early 80’s. Men should be tested when they begin to show signs of testosterone deficiency. Even men in their 30’s can be testosterone deficient and show signs of bone loss. Most men need to be tested around 50 years of age. It is never too late to benefit from hormone therapy.

Do women need progesterone when they use the pellets?

Any time estradiol is prescribed, progesterone is also prescribed. There are progesterone (not synthetic progestin) receptors in the bone, brain, heart, breast and uterus. Progesterone can be used as a topical cream, a vaginal cream, oral capsule, or sublingual drops or lozenges. If a patient is pre-menopausal she may use the progesterone the last two weeks of the menstrual cycle or as directed by the physician.

Do women need to be in menopause to benefit from pellets?

Hormone therapy with pellets is not just used for menopause. Women at any age may experience hormone imbalance. Levels decline or fluctuate contributing to debilitating symptoms. Pellets are useful in severe PMS, post-partum depression, menstrual or migraine headaches, and sleeping disorders. Pellets may also be used to treat hormone deficiencies caused by the birth control pill.

How are the hormones monitored during therapy?

Hormone levels will be drawn and evaluated before therapy is started. This will include a FSH, LH, estradiol, testosterone and testosterone for women. Men need a Prostate exam, PSA, estradiol, and testosterone. Levels will be reevaluated during hormone therapy at 4-6 weeks and again in 3-5 months. After the first years of therapy hormones levels are followed less frequently.